Department of Oral and Maxillofacial Surgery, German Armed Forces Central Hospital, Rübenacherstr. 170, 56072, Koblenz, Germany.
Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany.
Clin Oral Investig. 2024 Aug 26;28(9):501. doi: 10.1007/s00784-024-05898-7.
This study aimed to evaluate the use of botulinum toxin (BTX) for the treatment of bruxism in oral and maxillofacial surgery in Germany.
A dynamic online questionnaire comprising 7 to 25 questions was formulated to gather general and specific information regarding using BTX to treat bruxism. The questionnaire underwent internal and external assessments for validation. Subsequently, it was distributed to 906 oral and maxillofacial surgeons (OMFS) affiliated with the German Association for Oral and Maxillofacial Surgery (DGMKG). Weekly reminders were dispatched over four weeks to enhance response rates. Participation in the study was voluntary and anonymized. Descriptive methods were employed for data analysis.
107 OMFS participated in the study, yielding a response rate of 11.81%. On average, 17 patients with bruxism were per month, with 4 of these patients receiving BTX therapy. BTX administration was frequently accompanied by splints and physiotherapy (35.51% of participants). Botox® (Allergan) was the preferred BTX preparation, utilized by 40.79% and reconstituted with saline by 92.11% of participants. The masseter muscles were primarily targeted for BTX treatment (67.57% of participants), averaging 29 BTX (Allergan-) units per side. Injection points for each masseter muscle typically amounted to six per side, preferred by 30.67% of participants. Follow-up assessments post-BTX treatment were conducted regularly, predominantly after four weeks, by 36% of participants. In 8% of cases, additional BTX injections were necessary due to inadequate outcomes. Side effects were reported in 4% of cases, commonly manifesting as a non-disturbing reduction in bite force. Most participating OMFS (61.84%) using BTX for bruxism therapy regarded bruxism treatment with BTX as evidence-based. Notably, 97.37% of respondents expressed their willingness to recommend BTX-based bruxism treatment to their colleagues. Overall, the efficacy of BTX therapy for bruxism was rated as good (53.95%) and very good (40.79%).
The use of BTX for the management of bruxism among OMFS in Germany has demonstrated efficacy. Substantial variances in certain facets of bruxism treatment employing BTX have been observed.
Additional research endeavors are warranted to comprehensively investigate distinct elements of BTX therapy for bruxism, including the optimal dosage of BTX units and the precise localization of injection sites across various muscles.
本研究旨在评估肉毒毒素（BTX）在德国口腔颌面外科学中治疗磨牙症的应用。
设计了一份动态在线问卷，包含 7 至 25 个问题，以收集有关使用 BTX 治疗磨牙症的一般和具体信息。问卷经过内部和外部评估以验证其有效性。随后，将问卷分发给 906 名德国口腔颌面外科学会（DGMKG）附属的口腔颌面外科医生（OMFS）。四周内每周发送一次提醒以提高回复率。参与研究是自愿和匿名的。采用描述性方法进行数据分析。
107 名 OMFS 参与了研究，应答率为 11.81%。平均每月治疗 17 名磨牙症患者，其中 4 名患者接受 BTX 治疗。BTX 给药常伴有夹板和物理治疗（35.51%的参与者）。肉毒杆菌素（Allergan）是首选的 BTX 制剂，40.79%的参与者使用，92.11%的参与者用生理盐水配制。BTX 治疗主要针对咬肌（67.57%的参与者），每侧平均注射 29 个 BTX（Allergan-）单位。每侧咬肌的注射点通常为 6 个，30.67%的参与者首选。36%的参与者在 BTX 治疗后定期进行随访评估，主要在四周后进行。由于效果不理想，8%的情况下需要再次注射 BTX。4%的病例报告了副作用，通常表现为非干扰性的咬合力降低。大多数使用 BTX 治疗磨牙症的 OMFS（61.84%）认为 BTX 治疗磨牙症是基于证据的。值得注意的是，97.37%的受访者表示愿意向同事推荐基于 BTX 的磨牙症治疗。总体而言，BTX 治疗磨牙症的疗效被评为良好（53.95%）和非常好（40.79%）。
德国口腔颌面外科医生使用 BTX 治疗磨牙症已被证明是有效的。在使用 BTX 治疗磨牙症的某些方面存在显著差异。
需要进一步研究来全面调查 BTX 治疗磨牙症的不同要素，包括 BTX 单位的最佳剂量和在不同肌肉中注射点的精确定位。
